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Accumulated biomechanical effects of mandibular molar mesialization using clear aligners with auxiliary devices: an iterative finite element analysis. 下颌磨牙使用辅助装置的累积生物力学效应:迭代有限元分析。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-04-10 DOI: 10.1186/s40510-023-00462-7
Xinwei Lyu, Xing Cao, Luxian Chen, Yuyao Liu, Huilin Li, Cheng Hu, Jiali Tan

Background: The biomechanics generated by the clear aligner (CA) material changes continuously during orthodontic tooth movement, but this factor remains unknown during the computer-aid design process and the predictability of molars movement is not as expected. Therefore, the purpose of this study was to propose an iterative finite element method to simulate the long-term biomechanical effects of mandibular molar mesialization (MM) in CA therapy under dual-mechanical systems.

Methods: Three groups including CA alone, CA with a button, and CA with a modified lever arm (MLA) were created. Material properties of CA were obtained by in vitro mechanical experiments. MM was conducted by the rebound force exerted by CA material and the mesial elastic force (2N, 30° to the occlusal plane) applied to the auxiliary devices. Stress intensity and distribution on periodontal ligament (PDL), attachment, button and MLA, and displacement of the second molar (M2) during the iterations were recorded.

Results: There was a significant difference between the initial and cumulative long-term displacement. Specifically, compared to the beginning, the maximum stress of PDL decreased by 90% on average in the intermediate and final steps. The aligner was the main mechanical system at first, and then, the additional system exerted by the button and MLA dominated gradually. The stress of attachments and auxiliary devices is mainly concentrated on their interfaces with the tooth. Additionally, MLA provided a distal tipping and extrusive moment, which was the only group that manifested a total mesial displacement of the root.

Conclusions: The innovatively designed MLA was more effective in reducing undesigned mesial tipping and rotation of M2 than the traditional button and CA alone, which provided a therapeutic method for MM. The proposed iterative method simulated tooth movement by considering the mechanical characteristic of CA and its long-term mechanical force changes, which will facilitate better movement prediction and minimize the failure rate.

背景:在正畸牙齿运动过程中,CA材料产生的生物力学是不断变化的,但在计算机辅助设计过程中,这个因素仍然是未知的,磨牙运动的可预测性也不像预期的那样。因此,本研究的目的是提出一种迭代有限元方法来模拟双力学系统下下颌磨牙中化(MM)在CA治疗中的长期生物力学效应。方法:制作单纯CA组、带按钮CA组和改良杠杆臂CA组。Material通过体外力学实验获得了CA的性能。通过CA材料施加的回弹力和辅助装置施加的中弹力(2N,咬合平面30°)进行MM。记录迭代过程中牙周韧带(PDL)、附着体、扣层和MLA的应力强度和分布以及第二磨牙(M2)的位移。结果:初始位移与累积位移有显著性差异。其中,与开始阶段相比,中间和最后阶段PDL的最大应力平均下降了90%。起初,对准器是主要的机械系统,随后,由按钮和MLA施加的附加系统逐渐占主导地位。附着物和辅助装置的应力主要集中在其与齿的界面上。此外,MLA提供了远端倾斜和挤压力矩,这是唯一一组表现出根的全近端位移。结论:创新设计的MLA比传统的按钮和CA更有效地减少了M2的非设计中端倾斜和旋转,为MM的治疗提供了一种方法。所提出的迭代方法通过考虑CA的力学特性及其长期机械力变化来模拟牙齿的运动,有助于更好地预测运动,最大限度地降低故障率。
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引用次数: 1
Effectiveness of clear aligners in achieving proclination and intrusion of incisors among Class II division 2 patients: a multivariate analysis. 透明矫治器在实现 II 类 2 级患者门牙前倾和内陷方面的效果:多变量分析。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-04-03 DOI: 10.1186/s40510-023-00463-6
Xinyu Yan, Xiaoqi Zhang, Linghuan Ren, Yi Yang, Qingxuan Wang, Yanzi Gao, Qingsong Jiang, Fan Jian, Hu Long, Wenli Lai

Background: The predictability of incisor movement achieved by clear aligners among Class II division 2 patients is poorly understood. The aim of this retrospective study was to determine the effectiveness of clear aligners in proclining and intruding upper incisors and its influencing factors.

Methods: Eligible patients with Class II division 2 malocclusion were included. For clear aligner therapy, three types of incisor movements were designed: proclination, intrusion and labial movement. Pre-treatment and post-treatment dental models were superimposed. The differences between predicted and actual (DPA) tooth movement of incisors were analyzed. Univariate and multivariate linear regression were used to analyze the potential influencing factors.

Results: A total of 51 patients and their 173 upper incisors were included. Actual incisor proclination and intrusion were less than predicted ones (both P < 0.001), while actual labial movement was greater than predicted one (P < 0.001). Predictability of incisor proclination and intrusion was 69.8% and 53.3%, respectively. Multivariate linear regression revealed that DPA of proclination was significantly positively associated with predicted proclination (B = 0.174, P < 0.001), ipsilateral premolar extraction (B = 2.773, P < 0.001) and ipsilateral canine proclination (B = 1.811, P < 0.05), while negatively associated with molar distalization (B = - 2.085, P < 0.05). The DPA of intrusion was significantly positively correlated with predicted intrusion (B = 0.556, P < 0.001) while negatively associated with labial mini-implants (B = - 1.466, P < 0.001). The DPA of labial movement was significantly positively associated with predicted labial movement (B = 0.481, P < 0.001), while negatively correlated with molar distalization (B = - 1.004, P < 0.001), labial mini-implants (B = - 0.738, P < 0.001) and age (B = - 0.486, P < 0.05).

Conclusions: For Class II division 2 patients, predicted incisor proclination (69.8%) and intrusion (53.3%) are partially achieved with clear aligner therapy. Excessive labial movement (0.7 mm) of incisors may be achieved. Incisor movement is influenced by predicted movement amount, premolar extraction, canine proclination, molar distalization, mini-implants and age.

背景:人们对透明矫治器在二类二阶患者中实现切牙移动的可预测性知之甚少。这项回顾性研究旨在确定透明矫治器对上切牙前倾和内收的有效性及其影响因素:方法:纳入符合条件的 II 类 2 分区错颌畸形患者。在透明矫治器治疗中,设计了三种切牙移动方式:前倾、内收和唇侧移动。将治疗前和治疗后的牙齿模型叠加在一起。分析了门牙预测移动和实际移动(DPA)之间的差异。采用单变量和多变量线性回归分析潜在的影响因素:共纳入 51 名患者及其 173 颗上门牙。实际门牙前倾和内陷均小于预测值(均为 P 结论:对于 II 类 2 分区患者,预测值小于预测值,但实际门牙前倾和内陷均小于预测值:对于二类二分裂患者,透明矫治器治疗可部分实现预测的门牙前倾(69.8%)和内收(53.3%)。门牙可实现过度的唇侧移动(0.7 毫米)。门牙移动受预测移动量、前磨牙拔除、犬齿前倾、磨牙远端化、迷你种植体和年龄的影响。
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引用次数: 0
The transparency of reporting 'harms' encountered with the surgically assisted acceleration of orthodontic tooth movement in the published randomized controlled trials: a meta-epidemiological study. 在已发表的随机对照试验中,报告手术辅助加速正畸牙齿移动的“危害”的透明度:一项荟萃流行病学研究。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-03-21 DOI: 10.1186/s40510-023-00457-4
Doa'a Tahseen Alfailany, Mohammad Younis Hajeer, Khaldoun Darwich

Background: Surgical-assisted accelerated orthodontics (SAAO) has become very popular recently. Therefore, this study aimed to investigate the extent to which researchers adhere to Item 19 (harms) of the Consolidated Standards of Reporting Trials (CONSORT) in the published studies in the field of SAAO. In addition, the study evaluated the possible association between harm reporting and the human development index (HDI) of the recruited research sample country, CiteScore-based quartile (CSBQ) of the publishing journal, invasiveness of the surgical intervention (ISI), and the type of orthodontic tooth movement (TOTM). Moreover, it aimed to summarize the different possible harms and complications that maybe encountered in the course of SAAO.

Materials and methods: Electronic searching of six databases was conducted for SAAO-related English RCTs published between January 2000 and April 2022. For the RCTs that did not report harms, information was sought by contacting the corresponding authors. Descriptive statistics of the evaluated variables were performed. The association between 'harm reporting' and the HDI of the research team, the BDRQ of the publication journal, the ISI, and the TOTM were investigated. Binary logistic regression was used, and the odds ratios (ORs) with 95% confidence interval (CIs) of the evaluated variables were obtained. Moreover, the risk of bias of the included RCTs was assessed using the RoB2 tool.

Results: Among the 91 included RCTs, 54 RCTs (59.3%) did not adhere to reporting harm associated with the SAAO. The non-adherence was significantly associated with the ISI (OR 0.16; CI 0.03-0.73; p < 0.018) for invasive methods compared with minimally invasive ones). There was a significant positive correlation between harm reporting and both the CSBQ of the publishing journal and the HDI of the recruited research sample country (p = 0.001, p = 0.003, respectively). On the contrary, a non-significant association was found between harm reporting and the type of OTM (p = 0.695). The incidence of harms associated with SAAO was approximately 17.5%.

Limitations: Assessment was restricted to English RCTs related to SAAO.

Conclusion and implications: The adherence to reporting harms in the field of SAAO was deficient. Efforts should be made by authors, peer reviewers, and editors to improve compliance with the CONSORT guidelines regarding harms reporting. Additionally, there is a wide spectrum of harms that could be associated with SAAO that the practitioner should pay attention to and alert the patient to the possibility of their occurrence.

背景:手术辅助加速正畸(SAAO)近年来越来越流行。因此,本研究旨在调查研究人员在SAAO领域已发表的研究中遵守联合试验报告标准(CONSORT)第19项(危害)的程度。此外,本研究还评估了危害报告与所招募研究样本国家的人类发展指数(HDI)、发表期刊的citescore四分位数(CSBQ)、手术干预的侵入性(ISI)和正畸牙齿移动类型(TOTM)之间可能存在的关联。并总结SAAO过程中可能出现的各种危害和并发症。材料与方法:对2000年1月至2022年4月期间发表的saao相关英文rct进行6个数据库的电子检索。对于没有报告危害的随机对照试验,通过联系相应的作者来获取信息。对评估变量进行描述性统计。调查了“危害报告”与研究小组的HDI、出版期刊的BDRQ、ISI和TOTM之间的关系。采用二元logistic回归,获得评价变量的比值比(ORs)和95%置信区间(CIs)。此外,使用RoB2工具评估纳入的rct的偏倚风险。结果:在纳入的91项随机对照试验中,54项(59.3%)没有坚持报告与SAAO相关的危害。不依从性与ISI显著相关(OR 0.16;可信区间0.03 - -0.73;p局限性:评估仅限于与SAAO相关的英文rct。结论和意义:SAAO领域对报告危害的依从性不足。作者、同行审稿人和编辑应努力提高对CONSORT危害报告指南的遵守程度。此外,有广泛的危害可能与SAAO相关,医生应该注意并提醒患者他们发生的可能性。
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引用次数: 3
Incisor irregularity and dental arch dimensions changes in subjects with different severity of anterior crowding: a 37-year follow-up. 不同前牙拥挤程度受试者的切牙不规则和牙弓尺寸变化:37年随访。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-03-20 DOI: 10.1186/s40510-023-00461-8
Caroline Martins Gambardela-Tkacz, Gabriela Alcaraz, Paula Cotrin, Karina Maria Salvatore de Freitas, Willana Moura, Guilherme Janson, Daniela Garib, Marcos Roberto de Freitas

Background: Occlusal stability is one of the goals of orthodontic treatment, and keeping teeth aligned in the long term is a challenge for the orthodontist. This study aimed to compare the long-term incisors irregularity and dental arches dimensions changes in subjects treated with 4 premolar extractions with different pretreatment Little's irregularity index (LII). The knowledge of long-term outcomes is evidence-based information for the prognosis of future treatments.

Methods: In total, 41 treated subjects were divided into two groups according to mandibular Little irregularity value at pretreatment (mild or severe). The maxillary and mandibular LII, transversal, and longitudinal widths were assessed at pretreatment, posttreatment, and 37-year posttreatment. Chi-square and independent t tests were used for intergroup comparison.

Results: The groups presented similar behavior for all stages of maxillary and mandibular arch dimensions changes. Maxillary irregularity was corrected in both groups after treatment, and the alignment was acceptable in the long term. In the mild group, the mandibular incisor irregularity returned to pretreatment values in the long term. The mandibular LII increased in the severe group but did not return to pretreatment values in the long term.

Conclusions: The mild crowding group presented proportionally more relapse of mandibular incisor irregularity than the severe crowding group in the long term. Even so, the correction of mild and severe crowding with the extraction of 4 premolars showed satisfactory results in the long term, even with the presence of maturational changes and relapse.

背景:咬合稳定是正畸治疗的目标之一,长期保持牙齿排列对正畸医师来说是一个挑战。本研究旨在比较4种前磨牙拔牙后不同预处理方式的小不规则指数(LII)的长期门牙不规则度和牙弓尺寸的变化。对长期结果的了解是未来治疗预后的循证信息。方法:按预处理时下颌小不规则值(轻度和重度)分为两组,共41例。在治疗前、治疗后和治疗后37年评估上颌和下颌的LII、横向和纵向宽度。组间比较采用卡方检验和独立t检验。结果:两组在上颌弓和下颌骨各阶段的尺寸变化表现相似。治疗后两组上颌畸形均得到矫正,长期矫正效果良好。在轻度组,下颚切牙不平整恢复到长期的预处理值。重度组下颌骨LII升高,但长期未恢复到预处理值。结论:长期来看,轻度拥挤组下切牙畸形复发率高于重度拥挤组。尽管如此,通过拔除4颗前磨牙对轻度和重度拥挤的矫正,即使存在成熟的变化和复发,长期来看也取得了令人满意的效果。
{"title":"Incisor irregularity and dental arch dimensions changes in subjects with different severity of anterior crowding: a 37-year follow-up.","authors":"Caroline Martins Gambardela-Tkacz,&nbsp;Gabriela Alcaraz,&nbsp;Paula Cotrin,&nbsp;Karina Maria Salvatore de Freitas,&nbsp;Willana Moura,&nbsp;Guilherme Janson,&nbsp;Daniela Garib,&nbsp;Marcos Roberto de Freitas","doi":"10.1186/s40510-023-00461-8","DOIUrl":"https://doi.org/10.1186/s40510-023-00461-8","url":null,"abstract":"<p><strong>Background: </strong>Occlusal stability is one of the goals of orthodontic treatment, and keeping teeth aligned in the long term is a challenge for the orthodontist. This study aimed to compare the long-term incisors irregularity and dental arches dimensions changes in subjects treated with 4 premolar extractions with different pretreatment Little's irregularity index (LII). The knowledge of long-term outcomes is evidence-based information for the prognosis of future treatments.</p><p><strong>Methods: </strong>In total, 41 treated subjects were divided into two groups according to mandibular Little irregularity value at pretreatment (mild or severe). The maxillary and mandibular LII, transversal, and longitudinal widths were assessed at pretreatment, posttreatment, and 37-year posttreatment. Chi-square and independent t tests were used for intergroup comparison.</p><p><strong>Results: </strong>The groups presented similar behavior for all stages of maxillary and mandibular arch dimensions changes. Maxillary irregularity was corrected in both groups after treatment, and the alignment was acceptable in the long term. In the mild group, the mandibular incisor irregularity returned to pretreatment values in the long term. The mandibular LII increased in the severe group but did not return to pretreatment values in the long term.</p><p><strong>Conclusions: </strong>The mild crowding group presented proportionally more relapse of mandibular incisor irregularity than the severe crowding group in the long term. Even so, the correction of mild and severe crowding with the extraction of 4 premolars showed satisfactory results in the long term, even with the presence of maturational changes and relapse.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"24 1","pages":"10"},"PeriodicalIF":4.8,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10025172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9508754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Effects of IPR by mechanical oscillating strips system on biological structures: a quantitative and qualitative evaluation. 机械振荡条带系统IPR对生物结构的影响:定量和定性评价。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-03-13 DOI: 10.1186/s40510-023-00460-9
Francesca Gazzani, Denise Bellisario, Laura Fazi, Alessia Balboni, Silvia Licoccia, Chiara Pavoni, Paola Cozza, Roberta Lione

Background: To evaluate by means of profilometric analysis and scanning electronic microscope (SEM) the effects on enamel surfaces of oscillating mechanical systems for interproximal enamel reduction (IPR). Fifteen complete (Group 1) oscillating IPR sequence and 15 single metallic strips (Group 2) for active IPR phase of 0.2 mm were selected and tested on 30 freshly extracted teeth by means of tribological tests with alternative dry-sliding motion (Linear Reciprocating Tribometer, C.S.M. Instruments, Peseaux, Switzerland). Enamel surface roughness and waviness measurements were assessed by contact probe surface profiler (TalySurf CLI 2000; Taylor Hobson, Leicester, UK) and a TayMap software for the 3D analysis. Statistical analysis was performed with independent samples t-test. Significance was established at the P < .05 level. SEM analysis of enamel surfaces was conducted with a FEI Quanta 200 (Hillsboro, USA) in high vacuum at 30.00 kV. Images were acquired at 30X, 100X, and 300X of magnification.

Results: Teeth undergone Group 1 showed lower values of surface roughness (Ra - 0.34 µm, Rt - 1.55 µm) and significant increase of waviness parameters (Wa 0.25 µm, Wt 4.02 µm) when compared with those treated with Group 2. SEM evaluation showed smoothers and more regular surfaces when IPR was performed by complete IPR sequence. Single metallic strip determined more irregular surfaces characterized by extended grooves, alternated with enamel ridges and irregular fragments.

Conclusion: The adoption of a standardized oscillating IPR sequence determines more regular and harmonious enamel surfaces at the end of the procedure. An adequate polishing after IPR plays a crucial role to guarantee a good long-term prognosis and a good respect of biological structures.

背景:采用轮廓分析和扫描电镜(SEM)评价振荡机械系统对近端间牙釉质复位(IPR)牙釉质表面的影响。选择15个完整的(第1组)振荡IPR序列和15个0.2 mm主动IPR相位的单金属条(第2组),通过可选干滑动运动的摩擦学测试在30个刚拔出的牙齿上进行测试(Linear往复Tribometer, C.S.M. Instruments, Peseaux, Switzerland)。牙釉质表面粗糙度和波纹度测量采用接触探针表面轮廓仪(TalySurf CLI 2000;Taylor Hobson, Leicester, UK)和用于3D分析的TayMap软件。采用独立样本t检验进行统计学分析。结果:与组2相比,组1的牙齿表面粗糙度值较低(Ra - 0.34µm, Rt - 1.55µm),波浪度参数显著增加(Wa 0.25µm, Wt 4.02µm)。扫描电镜评价显示,完整的IPR序列进行IPR时,表面更加光滑和规则。单金属条确定了更多不规则的表面,其特征是延伸的凹槽,与珐琅脊和不规则碎片交替。结论:采用标准的IPR振荡序列可以在手术结束时确定更规则和和谐的牙釉质表面。IPR后适当的抛光对于保证良好的长期预后和良好的生物结构方面起着至关重要的作用。
{"title":"Effects of IPR by mechanical oscillating strips system on biological structures: a quantitative and qualitative evaluation.","authors":"Francesca Gazzani,&nbsp;Denise Bellisario,&nbsp;Laura Fazi,&nbsp;Alessia Balboni,&nbsp;Silvia Licoccia,&nbsp;Chiara Pavoni,&nbsp;Paola Cozza,&nbsp;Roberta Lione","doi":"10.1186/s40510-023-00460-9","DOIUrl":"https://doi.org/10.1186/s40510-023-00460-9","url":null,"abstract":"<p><strong>Background: </strong>To evaluate by means of profilometric analysis and scanning electronic microscope (SEM) the effects on enamel surfaces of oscillating mechanical systems for interproximal enamel reduction (IPR). Fifteen complete (Group 1) oscillating IPR sequence and 15 single metallic strips (Group 2) for active IPR phase of 0.2 mm were selected and tested on 30 freshly extracted teeth by means of tribological tests with alternative dry-sliding motion (Linear Reciprocating Tribometer, C.S.M. Instruments, Peseaux, Switzerland). Enamel surface roughness and waviness measurements were assessed by contact probe surface profiler (TalySurf CLI 2000; Taylor Hobson, Leicester, UK) and a TayMap software for the 3D analysis. Statistical analysis was performed with independent samples t-test. Significance was established at the P < .05 level. SEM analysis of enamel surfaces was conducted with a FEI Quanta 200 (Hillsboro, USA) in high vacuum at 30.00 kV. Images were acquired at 30X, 100X, and 300X of magnification.</p><p><strong>Results: </strong>Teeth undergone Group 1 showed lower values of surface roughness (Ra - 0.34 µm, Rt - 1.55 µm) and significant increase of waviness parameters (Wa 0.25 µm, Wt 4.02 µm) when compared with those treated with Group 2. SEM evaluation showed smoothers and more regular surfaces when IPR was performed by complete IPR sequence. Single metallic strip determined more irregular surfaces characterized by extended grooves, alternated with enamel ridges and irregular fragments.</p><p><strong>Conclusion: </strong>The adoption of a standardized oscillating IPR sequence determines more regular and harmonious enamel surfaces at the end of the procedure. An adequate polishing after IPR plays a crucial role to guarantee a good long-term prognosis and a good respect of biological structures.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"24 1","pages":"9"},"PeriodicalIF":4.8,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10008756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9481031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of the effects of different rapid maxillary expansion techniques on craniofacial structures: a finite element analysis study. 不同上颌快速扩张技术对颅面结构影响的比较:有限元分析研究。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-03-06 DOI: 10.1186/s40510-023-00459-2
Nihal Kaya, Elif Dilara Seker, Türker Yücesoy

Aim: To compare the effects of three different maxillary expansion appliances with five different types of expansion modalities on stress distribution and displacement on the maxilla and its adjacent craniofacial structures using the finite element method (FEM).

Materials and methods: Cone-beam computed tomography data of a patient with maxillary transverse deficiency were rendered into a three-dimensional model of craniomaxillary structures. The expansion appliances included tooth-borne, hybrid, and bone-borne expanders. Five different expansion modalities were applied to each expander [conventional Rapid Maxillary Expansion (RME) (type 1), midpalatal suture cortico-puncture-assisted RME (type 2), LeFort l cortico-puncture-assisted RME (type 3), surgically assisted RME (SARME) without pterygomaxillary junction (PMJ) separation (type 4), and SARME with bilateral PMJ separation (type 5)]. The numerical and visual data were analyzed.

Results: The highest amount of stress accumulation on teeth was found in the tooth-borne and hybrid groups. On the other hand, more stress concentration on the maxilla was observed in the bone-borne group. SARME cuts with PMJ separation increased total movement by reducing the stress on the midpalatal suture in all groups. While types 1, 2, and 3 were similar in terms of the amounts of displacement, types 4 and 5 increased the total amount of displacement in all groups. The total amounts of displacements from the highest value to the lowest value for the anterior and posterior maxilla were in the bone-borne, tooth-borne, and hybrid groups.

Conclusions: SARME cuts were effective in reducing stress on the teeth, but the cortico-puncture application affected neither the stress values on the teeth nor the transverse displacement in the tooth-borne expanders. Surgical procedures such as SARME and corticotomy should be used with bone-borne devices to improve the outcomes of maxillary expansion procedures.

目的:采用有限元法比较3种不同上颌扩展器、5种不同扩展方式对上颌及其邻近颅面结构应力分布和位移的影响。材料与方法:将1例上颌横断缺损患者的锥束计算机断层数据绘制成三维颅颌结构模型。扩展器具包括牙载、混合型和骨载扩展器。每个扩张器采用五种不同的扩张方式[常规快速上颌扩张(RME)(1型),中腭缝合皮质穿刺辅助RME(2型),LeFort 1皮质穿刺辅助RME(3型),手术辅助RME (SARME)不分离翼颌交界处(PMJ)(4型)和双侧PMJ分离的SARME(5型)]。对数值和视觉数据进行了分析。结果:牙源性组和杂交组牙体应力积累量最大。另一方面,骨载组在上颌骨上观察到更多的应力集中。在所有组中,经PMJ分离的SARME切口通过减少对中腭缝线的压力而增加了总运动。类型1、2和3的位移量相似,而类型4和5在所有组中都增加了总位移量。前、后上颌移位总量由最大值到最小值依次为骨载组、牙载组和杂交组。结论:SARME切口能有效降低牙体应力,但皮质穿刺不影响牙体应力值,也不影响牙体扩张器的横向位移。外科手术如SARME和皮质切开术应与骨载装置一起使用,以改善上颌扩张手术的结果。
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引用次数: 1
Stress distribution and displacement in the maxillofacial complex during intrusion and distalization of the maxillary arch using miniplates versus mini-implants: a 3-dimensional finite element study. 微型钢板与微型种植体在上颌弓内伸和外伸过程中颌面复合体的应力分布和位移:三维有限元研究
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-03-01 DOI: 10.1186/s40510-023-00455-6
Abinaya Somaskandhan, N M Vijay Kumar, R Devaki Vijayalakshmi

Objectives: To three-dimensionally analyse the stress distribution and displacement pattern in the maxillofacial complex following intrusion and distalization of the maxillary arch using finite element analysis in skeletal class II malocclusion with prognathic maxilla and vertical maxillary excess using miniplates and mini-implants.

Materials and methods: Finite Element models of a skull, Y-shaped stainless steel miniplate, mini-implant and a posted arch were generated. Three force levels (1) 200 g (2) 300 g and (3) 500 g per side were applied to the assembly. The models were pre-processed and the analysis was performed using ANSYS version 18.1 software. Alterations in von mises stress, principal maximum stress, principal minimum stress and compressive stress were analysed around the sutures and surface landmarks.

Results: With miniplates, there was a maximum stress concentration at the zygomatic buttress with even stress distribution at the fronto-maxillary, zygomatico-temporal, zygomatico-frontal and pterygomaxillary sutures along with anatomical landmarks such as frontal process of maxilla, ANS, Point A, prosthion and maxillary process of zygoma. First molars experienced greater distalization effects with buccal flaring when miniplates were used. With mini-implants, canine and premolars also exhibited greater distalization effects. In the root apices, lateral incisors showed increased lingual root movement with mini-implants.

Conclusion: Miniplates provide a greater distalizing effect while mini-implants produce increased intrusive effect. The distalizing effect is greater when 500 g of force is applied using miniplates with significantly even stress distribution and displacement pattern.

目的:应用有限元分析方法,对颌骨ⅱ类错颌前颌和垂直上颌过度患者应用微型钢板和微型种植体进行上颌弓突突和远突后颌面复合体的应力分布和位移模式进行三维分析。材料与方法:制作颅骨、y形不锈钢微型钢板、微型种植体和立柱弓的有限元模型。组件每侧施加三个力水平(1)200g (2) 300g和(3)500g。采用ANSYS 18.1版软件对模型进行预处理和分析。在缝合处和表面标志处分析von mises应力、主最大应力、主最小应力和压应力的变化。结果:微型钢板在颧支撑处应力集中最大,在前颌缝、颧颞缝、颧额缝、翼颌缝处应力分布均匀,且在上颌骨额突、ANS、a点、假体、颧突等解剖标志处应力分布均匀。第一磨牙在使用微型牙板时,有较好的远端效果。使用微型种植体,犬齿和前磨牙也表现出更大的远端效果。在根尖,侧切牙显示增加舌根运动与微型种植体。结论:小型钢板具有较好的离体效果,而小型种植体具有较强的侵入性。当使用应力分布和位移模式明显均匀的微型板施加500g力时,远距效果更大。
{"title":"Stress distribution and displacement in the maxillofacial complex during intrusion and distalization of the maxillary arch using miniplates versus mini-implants: a 3-dimensional finite element study.","authors":"Abinaya Somaskandhan,&nbsp;N M Vijay Kumar,&nbsp;R Devaki Vijayalakshmi","doi":"10.1186/s40510-023-00455-6","DOIUrl":"https://doi.org/10.1186/s40510-023-00455-6","url":null,"abstract":"<p><strong>Objectives: </strong>To three-dimensionally analyse the stress distribution and displacement pattern in the maxillofacial complex following intrusion and distalization of the maxillary arch using finite element analysis in skeletal class II malocclusion with prognathic maxilla and vertical maxillary excess using miniplates and mini-implants.</p><p><strong>Materials and methods: </strong>Finite Element models of a skull, Y-shaped stainless steel miniplate, mini-implant and a posted arch were generated. Three force levels (1) 200 g (2) 300 g and (3) 500 g per side were applied to the assembly. The models were pre-processed and the analysis was performed using ANSYS version 18.1 software. Alterations in von mises stress, principal maximum stress, principal minimum stress and compressive stress were analysed around the sutures and surface landmarks.</p><p><strong>Results: </strong>With miniplates, there was a maximum stress concentration at the zygomatic buttress with even stress distribution at the fronto-maxillary, zygomatico-temporal, zygomatico-frontal and pterygomaxillary sutures along with anatomical landmarks such as frontal process of maxilla, ANS, Point A, prosthion and maxillary process of zygoma. First molars experienced greater distalization effects with buccal flaring when miniplates were used. With mini-implants, canine and premolars also exhibited greater distalization effects. In the root apices, lateral incisors showed increased lingual root movement with mini-implants.</p><p><strong>Conclusion: </strong>Miniplates provide a greater distalizing effect while mini-implants produce increased intrusive effect. The distalizing effect is greater when 500 g of force is applied using miniplates with significantly even stress distribution and displacement pattern.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"24 1","pages":"8"},"PeriodicalIF":4.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9975133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10829171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
A quantitative three-dimensional comparative study of alveolar bone changes and apical root resorption between clear aligners and fixed orthodontic appliances. 透明矫正器与固定矫治器牙槽骨变化及根尖吸收的定量三维比较研究。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-02-27 DOI: 10.1186/s40510-023-00458-3
Ibtehal Almagrami, Abeer A Almashraqi, Bushra Sufyan Almaqrami, Amin S Mohamed, Khaled Wafaie, Maher Al-Balaa, Yiqiang Qiao

Background: This study aimed to evaluate and compare the alveolar bone changes and to investigate the prevalence and severity of orthodontically induced inflammatory root resorption (OIIRR) of maxillary incisors in patients who received treatment with clear aligners (CA) versus conventional fixed appliances (FA), using cone-beam computed tomography (CBCT).

Methods: One hundred sixty maxillary incisors from 40 patients with similar baseline characteristics based on the American Board of Orthodontics discrepancy index scores were divided into the CA and FA groups. The dentoalveolar quantitative changes were analyzed using pre- (T0) and post-treatment (T1) CBCT. The measured parameters included alveolar bone thickness (ABT), alveolar bone height (ABH), root length (OIIRR), and maxillary incisor inclinations.

Results: Post-treatment, the average palatal and total ABT significantly decreased in central and lateral incisors in the FA group. In contrast, the CA group's average labial ABT of the lateral incisors decreased considerably. Regarding the ABH, both groups showed significant labial and palatal marginal bone resorption. In both groups, root lengths significantly decreased after treatment (p < 0.005). The inter-group comparison revealed that ABT and root length had significantly decreased in the FA group compared to the CA group, while the ABH showed no significant difference between the two groups. The mean absolute reductions of ABT and OIIRR in the CA group were significantly less (- 0.01 ± 0.89 and 0.31 ± 0.42) than those in the FA group (0.20 ± 0.82 and 0.68 ± 0.97), respectively.

Conclusions: CA and FA treatments appear to cause a significant ABT reduction and a statistically significant increased OIIRR in the maxillary incisor region, with a greater extent expected with FA treatment. However, the increased OIIRR values in the majority of both groups' cases were not clinically significant. Both treatment modalities resulted in a significant ABH reduction, with the highest found in the labial side of lateral incisors in the CA group.

背景:本研究旨在通过锥形束计算机断层扫描(CBCT)评估和比较接受透明矫正器(CA)和传统固定矫治器(FA)治疗的上颌门牙正畸诱导的炎症性牙根吸收(OIIRR)的患病率和严重程度。方法:选取基线特征相似的40例患者160颗上颌切牙,根据美国正畸委员会差异指数评分分为CA组和FA组。采用治疗前(T0)和治疗后(T1) CBCT分析牙槽牙的定量变化。测量参数包括牙槽骨厚度(ABT)、牙槽骨高度(ABH)、牙根长度(OIIRR)和上颌切牙倾斜度。结果:FA组治疗后中、侧切牙平均腭ABT和总ABT均显著降低。相比之下,CA组侧切牙的平均唇侧ABT明显下降。在ABH方面,两组均表现出明显的唇缘和腭缘骨吸收。两组患者治疗后根长均显著减少(p)。结论:CA和FA治疗明显降低了上颌切牙区域的ABT,统计学上显著增加了上颌切牙区域的OIIRR, FA治疗的预期效果更大。然而,两组病例中大多数病例的OIIRR值升高没有临床意义。两种治疗方式均可显著减少ABH, CA组侧切牙唇侧ABH减少最多。
{"title":"A quantitative three-dimensional comparative study of alveolar bone changes and apical root resorption between clear aligners and fixed orthodontic appliances.","authors":"Ibtehal Almagrami,&nbsp;Abeer A Almashraqi,&nbsp;Bushra Sufyan Almaqrami,&nbsp;Amin S Mohamed,&nbsp;Khaled Wafaie,&nbsp;Maher Al-Balaa,&nbsp;Yiqiang Qiao","doi":"10.1186/s40510-023-00458-3","DOIUrl":"https://doi.org/10.1186/s40510-023-00458-3","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate and compare the alveolar bone changes and to investigate the prevalence and severity of orthodontically induced inflammatory root resorption (OIIRR) of maxillary incisors in patients who received treatment with clear aligners (CA) versus conventional fixed appliances (FA), using cone-beam computed tomography (CBCT).</p><p><strong>Methods: </strong>One hundred sixty maxillary incisors from 40 patients with similar baseline characteristics based on the American Board of Orthodontics discrepancy index scores were divided into the CA and FA groups. The dentoalveolar quantitative changes were analyzed using pre- (T0) and post-treatment (T1) CBCT. The measured parameters included alveolar bone thickness (ABT), alveolar bone height (ABH), root length (OIIRR), and maxillary incisor inclinations.</p><p><strong>Results: </strong>Post-treatment, the average palatal and total ABT significantly decreased in central and lateral incisors in the FA group. In contrast, the CA group's average labial ABT of the lateral incisors decreased considerably. Regarding the ABH, both groups showed significant labial and palatal marginal bone resorption. In both groups, root lengths significantly decreased after treatment (p < 0.005). The inter-group comparison revealed that ABT and root length had significantly decreased in the FA group compared to the CA group, while the ABH showed no significant difference between the two groups. The mean absolute reductions of ABT and OIIRR in the CA group were significantly less (- 0.01 ± 0.89 and 0.31 ± 0.42) than those in the FA group (0.20 ± 0.82 and 0.68 ± 0.97), respectively.</p><p><strong>Conclusions: </strong>CA and FA treatments appear to cause a significant ABT reduction and a statistically significant increased OIIRR in the maxillary incisor region, with a greater extent expected with FA treatment. However, the increased OIIRR values in the majority of both groups' cases were not clinically significant. Both treatment modalities resulted in a significant ABH reduction, with the highest found in the labial side of lateral incisors in the CA group.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"24 1","pages":"6"},"PeriodicalIF":4.8,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9367914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Stress and movement trend of lower incisors with different IMPA intruded by clear aligner: a three-dimensional finite element analysis. 不同IMPA下门牙被清晰矫正器侵入的应力和运动趋势:三维有限元分析。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-02-13 DOI: 10.1186/s40510-023-00454-7
Yixin Li, Shengzhao Xiao, Yu Jin, Cheng Zhu, Ruomei Li, Yikan Zheng, Rongjing Chen, Lunguo Xia, Bing Fang

Background: During the intrusion of lower incisors with clear aligners (CAs), root disengagement from the alveolar bone often occurs, resulting in serious complications. This study aimed to determine the potential force mechanism of the mandibular anterior teeth under the pressure of CA, providing theoretical data for clinical practice.

Methods: In this study, a 3D finite element model was established, including the CA, periodontal ligament, and mandibular dentition. Incisor mandibular plane angles were set as 5 groups: 90°, 95°, 100°, 105°, and 110°. The 4 mandibular incisors were intruded by 0.2 mm, while the canines were the anchorage teeth. The stress, force systems, and potential movement trends of mandibular anterior teeth were obtained.

Results: The compressive stress of the incisors was concentrated in the lingual fossa, incisal ridge, and apex. With the increase in IMPA, the moment of central incisors changed from lingual crown moment to labial crown moment, with the turning point between 100° and 105°, but the center of resistance (CR) was always subjected to the force toward the lingual and intrusive direction. The force and moment toward the labial side of the lateral incisors were greater than those toward the central incisors. The canines always tipped distally and received extrusive force with no relationship with IMPA.

Conclusions: With the increase in the initial IMPA, the direction of labiolingual force on the mandibular incisors was reversed. However, the root of the lower incisors always tipped labially, which indicated fenestration and dehiscence.

背景:下门牙植入牙槽骨矫正器(ca)时,经常发生牙根与牙槽骨脱离,导致严重的并发症。本研究旨在探讨下颌前牙在CA压力下的潜在受力机制,为临床实践提供理论依据。方法:建立CA、牙周韧带、下颌牙列三维有限元模型。切下颌平面角设为90°、95°、100°、105°、110°5组。4个下切牙内嵌0.2 mm,犬齿为支抗牙。获得了下颌前牙的应力、受力系统和潜在的运动趋势。结果:切牙的压应力主要集中在舌窝、切脊和牙尖。随着IMPA的增加,中切牙的弯矩由舌冠弯矩转变为唇冠弯矩,弯矩在100°~ 105°之间,但阻力中心(CR)始终受到向舌突方向的作用力。侧切牙朝向唇侧的力和力矩大于中切牙朝向唇侧的力和力矩。犬齿总是向远端倾斜并受到挤压力,与IMPA无关。结论:随着初始内压的增加,下切牙唇舌受力方向发生逆转。但下门牙的牙根总是向唇尖倾斜,这表明开窗和开裂。
{"title":"Stress and movement trend of lower incisors with different IMPA intruded by clear aligner: a three-dimensional finite element analysis.","authors":"Yixin Li,&nbsp;Shengzhao Xiao,&nbsp;Yu Jin,&nbsp;Cheng Zhu,&nbsp;Ruomei Li,&nbsp;Yikan Zheng,&nbsp;Rongjing Chen,&nbsp;Lunguo Xia,&nbsp;Bing Fang","doi":"10.1186/s40510-023-00454-7","DOIUrl":"https://doi.org/10.1186/s40510-023-00454-7","url":null,"abstract":"<p><strong>Background: </strong>During the intrusion of lower incisors with clear aligners (CAs), root disengagement from the alveolar bone often occurs, resulting in serious complications. This study aimed to determine the potential force mechanism of the mandibular anterior teeth under the pressure of CA, providing theoretical data for clinical practice.</p><p><strong>Methods: </strong>In this study, a 3D finite element model was established, including the CA, periodontal ligament, and mandibular dentition. Incisor mandibular plane angles were set as 5 groups: 90°, 95°, 100°, 105°, and 110°. The 4 mandibular incisors were intruded by 0.2 mm, while the canines were the anchorage teeth. The stress, force systems, and potential movement trends of mandibular anterior teeth were obtained.</p><p><strong>Results: </strong>The compressive stress of the incisors was concentrated in the lingual fossa, incisal ridge, and apex. With the increase in IMPA, the moment of central incisors changed from lingual crown moment to labial crown moment, with the turning point between 100° and 105°, but the center of resistance (CR) was always subjected to the force toward the lingual and intrusive direction. The force and moment toward the labial side of the lateral incisors were greater than those toward the central incisors. The canines always tipped distally and received extrusive force with no relationship with IMPA.</p><p><strong>Conclusions: </strong>With the increase in the initial IMPA, the direction of labiolingual force on the mandibular incisors was reversed. However, the root of the lower incisors always tipped labially, which indicated fenestration and dehiscence.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"24 1","pages":"5"},"PeriodicalIF":4.8,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9922685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10712540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
The effect of orthodontic treatment on smile attractiveness: a systematic review. 正畸治疗对微笑吸引力的影响:系统性综述。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-02-06 DOI: 10.1186/s40510-023-00456-5
G Coppola, I Christopoulou, N Gkantidis, C Verna, N Pandis, G Kanavakis

Background: Smile attractiveness is a primary factor for patients to seek orthodontic treatment, however, there is yet no systematic evaluation of this topic in the literature.

Objectives: To assess the current evidence on the effect of orthodontic treatment on smile attractiveness.

Search methods: Seven electronic databases (MEDLINE, Cochrane Library, Virtual Health Library, SCOPUS, Web of Science, Google Scholar and Embase) were searched on 14 September 2022.

Selection criteria: Studies evaluating smile attractiveness before and after orthodontic treatment or only after completion of orthodontic treatment.

Data collection and analysis: Extracted data included study design and setting, sample size and demographics, malocclusion type, treatment modality and method for outcome assessment. Risk of bias was assessed with the ROBINS-I tool for non-randomised studies. Random-effects meta-analyses of mean differences and their 95% confidence intervals (CIs) were planned a priori.

Methods: After elimination of duplicate studies, data extraction and risk of bias assessment according to the Cochrane guidelines, an evaluation of the overall evidence was performed. The included studies were evaluated based on the characteristics of their study and control groups and based on their main research question. Also, all outcome measures were standardized into a common assessment scale (0-100), in order to obtain more easily interpretable results.

Results: Ten studies were included in this review, nine of which were assessed as being at serious risk of bias and one at moderate risk of bias. The large heterogeneity between the included studies did not allow for a meta-analysis. Orthodontic treatment has a moderately positive effect on smile attractiveness. When compared to no treatment, orthodontic treatment with premolar extractions improves smile attractiveness by 22%. Also, surgical correction of Class III cases increases smile attractiveness by 7.5% more than camouflage treatment. No other significant differences were shown between different types of treatment.

Conclusion: Based on the available data, orthodontic treatment seems to moderately improve the attractiveness of the smile. There is significant bias in the current literature assessing the effect of orthodontics on smile attractiveness; therefore, the results cannot be accepted with certainty.

背景:微笑的吸引力是患者寻求正畸治疗的首要因素:微笑吸引力是患者寻求正畸治疗的首要因素,然而,目前尚无文献对这一主题进行系统评估:评估正畸治疗对微笑吸引力影响的现有证据:检索方法:于 2022 年 9 月 14 日检索了七个电子数据库(MEDLINE、Cochrane Library、Virtual Health Library、SCOPUS、Web of Science、Google Scholar 和 Embase):数据收集与分析:提取的数据包括研究设计和环境、样本量和人口统计学、错颌畸形类型、治疗方式和结果评估方法。采用ROBINS-I工具对非随机研究的偏倚风险进行评估。对平均差异及其 95% 置信区间(CIs)进行随机效应荟萃分析是事先计划好的:根据 Cochrane 指南剔除重复研究、提取数据并评估偏倚风险后,对总体证据进行评估。根据研究组和对照组的特点以及主要研究问题对纳入的研究进行了评估。此外,为了获得更易于解释的结果,还将所有结果测量标准化为一个通用的评估量表(0-100):本综述共纳入 10 项研究,其中 9 项被评估为存在严重偏倚风险,1 项存在中度偏倚风险。由于所纳入的研究之间存在较大的异质性,因此无法进行荟萃分析。正畸治疗对微笑的吸引力有适度的积极影响。与不进行治疗相比,拔除前磨牙的正畸治疗可将微笑吸引力提高 22%。此外,对 III 类病例进行手术矫正比伪装治疗可提高微笑吸引力 7.5%。不同类型的治疗之间没有其他明显差异:根据现有数据,正畸治疗似乎能适度提高微笑的吸引力。在评估正畸对微笑吸引力的影响方面,目前的文献存在很大的偏差;因此,不能肯定地接受这些结果。
{"title":"The effect of orthodontic treatment on smile attractiveness: a systematic review.","authors":"G Coppola, I Christopoulou, N Gkantidis, C Verna, N Pandis, G Kanavakis","doi":"10.1186/s40510-023-00456-5","DOIUrl":"10.1186/s40510-023-00456-5","url":null,"abstract":"<p><strong>Background: </strong>Smile attractiveness is a primary factor for patients to seek orthodontic treatment, however, there is yet no systematic evaluation of this topic in the literature.</p><p><strong>Objectives: </strong>To assess the current evidence on the effect of orthodontic treatment on smile attractiveness.</p><p><strong>Search methods: </strong>Seven electronic databases (MEDLINE, Cochrane Library, Virtual Health Library, SCOPUS, Web of Science, Google Scholar and Embase) were searched on 14 September 2022.</p><p><strong>Selection criteria: </strong>Studies evaluating smile attractiveness before and after orthodontic treatment or only after completion of orthodontic treatment.</p><p><strong>Data collection and analysis: </strong>Extracted data included study design and setting, sample size and demographics, malocclusion type, treatment modality and method for outcome assessment. Risk of bias was assessed with the ROBINS-I tool for non-randomised studies. Random-effects meta-analyses of mean differences and their 95% confidence intervals (CIs) were planned a priori.</p><p><strong>Methods: </strong>After elimination of duplicate studies, data extraction and risk of bias assessment according to the Cochrane guidelines, an evaluation of the overall evidence was performed. The included studies were evaluated based on the characteristics of their study and control groups and based on their main research question. Also, all outcome measures were standardized into a common assessment scale (0-100), in order to obtain more easily interpretable results.</p><p><strong>Results: </strong>Ten studies were included in this review, nine of which were assessed as being at serious risk of bias and one at moderate risk of bias. The large heterogeneity between the included studies did not allow for a meta-analysis. Orthodontic treatment has a moderately positive effect on smile attractiveness. When compared to no treatment, orthodontic treatment with premolar extractions improves smile attractiveness by 22%. Also, surgical correction of Class III cases increases smile attractiveness by 7.5% more than camouflage treatment. No other significant differences were shown between different types of treatment.</p><p><strong>Conclusion: </strong>Based on the available data, orthodontic treatment seems to moderately improve the attractiveness of the smile. There is significant bias in the current literature assessing the effect of orthodontics on smile attractiveness; therefore, the results cannot be accepted with certainty.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"24 1","pages":"4"},"PeriodicalIF":4.8,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9899877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10667792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Progress in Orthodontics
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